Krugman: Health Care Realities
“At a recent town hall meeting, a man stood up and told Representative Bob Inglis to ‘keep your government hands off my Medicare.’ The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, ‘wasn’t having any of it.’”
LINK: Health Care Realities
“Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.
Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare.”
We’ve got a long few months ahead as we argue about healthcare in the U.S.
Thanks, Torrie, for sending in this link. o
- 07.31.2009
- 19 Responses »
- healthcare, Krugman, link, nytimes, u.s. healthcare
- link
The big claim is “government involvement is the only reason our system works at all.” But the only support he offers is government regulation forbidding employers from offering health coverage from discriminating on pre-existing conditions, or offering selective benefits.
That’s an important point, but it’s less than persuasive for so sweeping a thesis statement.
All the talk of Medicaid and Medicare is secondary, as he’s trying to explain why people outside those programs are satisfied.
And Medicare is a terrible model; the program is a fiscal catastrophe.
I’m so entirely tired of listening to the Chicken Littles exclaiming that the sky is falling, we’re headed toward socialized medicine, and socialism in general. Insurance of any kind, by its very nature, is socialistic: the many pay for the few.
So the question then is how to make it effective to all – which means that there needs to be some sort of public option. In countries beyond our own, they are baffled that we still have health insurance as part of the employment world, no others do this. But then, we couldn’t even figure out how to get in line with the rest of the world on the Metric system. It’s no wonder we spend so much for for so little health care as compared to every single other industrialized country on this earth.
The ad campaign and speech from the right are disgusting and just plain wrong, as in ‘incorrect’, AND wrong, as in ‘the wrong thing to do’.
The lack of a Public Option in the final conversation will be an opportunity lost, and time wasted.
So go ahead, you Righties, and you Blue Dog DINOs, deregulate everything and let the ‘free market forces’ take care of everything – it’s worked out really well so far, don’t you think? Hope you don’t get sick any time soon.
This comment really belongs on your entry “More on Healthcare” but since this is more current here goes:
Regarding Regans original comment:
“In this present crisis Government is not the solution to our problem. Government is the problem.”
Unfortunately, this now seems more true than ever. Not that our government shouldn’t provide healthCARE to all it’s citizens because it is the right thing as a civilized nation to do. Or even that it is incapable of doing so as the Right wing try to scare the population into believing.
No, I fear that this is true now because our lawmakers are so corrupted by the money of the special interest groups like the insurance lobby that they no longer govern in the best interest of our citizens. The result being a bad bill that ends up locking in more billions in profits for a callous industry that clearly cares only about profits and nothing about health CARE for it’s policy holders.
And while I agree with your previous post about health insurance reform, really that is not at all adequate. The country needs a comprehensive health CARE policy, not a patchwork of health INSURANCE reforms to try and force the industry to perform. Howard Dean, who has really been well positioned to speak coherently on the health care debate, was right on the money when he said that if insurance industry reform is what this has become then lets take all the money off the table, write the new regulations which can be imposed for nothing, and then come back and address health CARE with a different bill.
My opinion is that the only way to get real health CARE for the citizens of our country is to eliminate the profit motive and move to a single payer system as the rest of the industrialized nations of the world have done for their citizens. This is the real fight that Obama should be taking on while he has the political capital. Not simply insurance reform but a lasting progressive public healthcare program.
In your reading please consider this…
http://www.oftwominds.com/blog.html
…the July 31st post. Obviously, it is a follow-up from a previous post, and the issue, of course, is complicated. My instinct is to say we are coming at this from the wrong angle. But then sometimes I am ashamed to say that I almost give up attempting to explain what I think is common sense cause I’m wasting time with my son by doing so. And what will happen…well, it will just happen I guess. Everyone that can’t get private health insurance will get government sponsored health insurance and the world will be a better place. You know what…I hope that happens. I really do.
A couple of weeks ago I was at home sitting on my parents’ back porch enjoying the time with family. My sister-in-law, who is a very bright, late-twenties woman on the brink of getting her BS in nursing, was lamenting over what the following day at work would hold. I asked her how bad it could be and she went on to explain to me that the pain clinic she worked for in a mid-size southern town had 100 patients scheduled in a 7.5 hour period. The doctor, who is just the greatest guy EVER, paid 1.4 million in taxes last year. You know what…good for the doctor….good for all those patients that need to be relieved of pain….good for the broke government that is now planning on paying for some of that….well, hell, they already are and who am I to say who’s in pain?
I don’t know, Jon, I don’t know much really….but sometimes it feels like things have gone too wrong.
I try to be positive, I promise.
Thank you for the discussion. I do appreciate your thorough study of this issue.
I’m a 24 year old college graduate in very good health. My fiancee and I just found out we are expecting our first baby next spring, and so I called my private insurance, Aetna, to see about adding maternity coverage to my plan (‘m the one carrying the kid, after all).
Not. So. Much.
They “don’t offer any maternity or prenatal coverage to women on individual insurance plans in Arizona”. They, will however, cover complications of pregnancy, the chances of which I feel would lessen if I had access to good, affordable prenatal care. Right?
So I shopped around. Turns out, being pregnant is right up their with frigging cancer or another terminal disease, because insurance companies like Cigna, Humana (HA!), and United One Healthcare will not begin to include maternity benefits until you have been on the plan for up to 21 MONTHS. SERIOUSLY.
My employer’s next open enrollment on their insurance isn’t until December 2009, at which time they assured me they can add me to their group plan, even in my condition. This is a relief, but there is much ado in the meantime in terms of doctor visits, donograms, possible tests, etc.
Much to my chagrin, I looked into AZ medicaid- I make $150 more per month than is eligable to qualify. Seriously.
So my only choices are to pay my prenatals out of pocket until December (which will not be fun on relatively low first-real-job salary), or get hitched right away to be able to enjoy the good benefits of my fiancee’s job. I do have options, but I’d rather not have to enter into a legally binding marital contract on threat of having to pay my doctor bills.
I fully admit I am young and know hardly anything about the insurance or healthcare businesses, a blessed curse for having good healthcare coverage as a child and all the way through college.
Thanks for speaking up for us little peeps, Jon.
Jon, why do you think the world comes to us for health care? It’s not perfect but it only needs a good plan for small businesses and individuals. Please come down South, please visit Mansfield, LA, OR ANY OTHER SMALL TOWN IN THE SOUTH. There is a huge sector that does not want to work, that wants government (read the middle class) to pay for them. They skirt every law to get free money from the government en masse, not just a few. I do not want to pay for them or non-citizens from Mexico. Do you want your daughters to carry the weight of America on their backs? YOU CAN’T MAKE ENOUGH MONEY TO HELP THEM. I have a son at LSU and it has taken over $60,000 to fund him for four years, he still has a year and a half to go. My husband and I are strict middle class. You are insulated in your environment. Think about it…please.
You must be joking and your comment sounds like thinly veiled racism.
from http://medicaltourismguide.org/ :
Your comment is pregnant with irony about an insulated environment. You are unaware of how the middle class was created as well as delusional that the U.S. is a sought after destination for medical tourists.
I AM THINKING ABOUT IT. I’m looking at every other industrialized nation in the world. The U.S. is behind in its thinking and approach in regards to healthcare and health insurance.
Jon…
Stop being PC for the love of God. The man is right.
Not every truth is racism. This is why the liberal viewpoint seems so absolutely adolescent at times. If someone points out the truth of society, well, then they must be racist. Give me a damn break.
I will push you again about what poverty you see regularly. How many people on government aid do you know or been around? I am thinking very little.
Because if you had, then you would realize the reality of it. It isn’t all some Thoreau idea of social injustice Jon. There are sorry, lazy people out there who take total advantage of others. They exist. And no amount of your fluffy idealogy will change the fact that isn’t FAIR. Isn’t it all about fairness for you? Well, what about the people paying for these leeches on society? Or is it only fairness for people who are deemed socially oppressed?
Can’t you see where all this social correctness and engineering leads?
I guess not.
My suggestion to you Jon…your next permanent vacation should be off this list if you hate this country so damn much. You live here and should have more pride of place man, seriously. It’s getting old hearing both you and Obama talk about how every place is better than America. If you don’t like it here, you always have the option to leave you know. But I honestly think this is just a simple case of “the grass is always greener”, which totally backs up my theory that you are thinking about this in a very naive way. Go to Canada for a year or two and then get back to us.
No, government run programs don’t ration care and the English get great care…
well ask the thousands affected by this:
http://www.telegraph.co.uk/health/healthnews/5955840/Patients-forced-to-live-in-agony-after-NHS-refuses-to-pay-for-painkilling-injections.html
Private insurance rations healthcare. If you can’t see that you haven’t read my links.
Jon…you are a smart guy. I know that. See what you are saying here…that you’re ok with the GOVERNMENT rationing care, that that is OK for you, but you aren’t with private insurance doing it!!!! That makes no sense.
Ok, fine…no one wants rationing, so let’s work on that instead of moving the beast from one bad place to a totally NEW BAD PLACE, ie the government.
At least in the private sector people have options, though as we’ve discussed it’s limited access via state limits. This is where reform needs to focus, but no one seems to even be interested in that area, but some conservatives. I don’t give a shit who reforms these problems, I just want them to not have total control over what happens to people.
Here’s yet one more example, just to show you, and hopefully get you to see your gov option is no better…it will still be super expensive, limited and poor quality…but with absolutely NO recourse for anyone then. You can’t sue the government…you can’t even really appeal to it. So then when the hammer comes down, where do you go? Oh, that’s right…to the voting box in a few YEARS to teach those politicians a lesson. What good will that do the people needing care Jon? Do you honestly think those bastards will care once it’s all in place. They have their own premium government insurance for their healthcare!! What do they care if people are suffering and dying? Hell, they barely care now.
http://hotair.com/archives/2009/08/03/video-oregon-says-no-to-chemotherapy-offers-assisted-suicide-instead/
And remember, Heather just had a family member with cancer. How would she have felt if he had received this kind of letter?
Jon, Come be 55 with me. You live in a utopia that most people do not get to experience. Let those two precious girls of yours get a little older and I guarantee you will have a vastly different opinion of life than the “let’s give this a try, he seems reasonalbe EXCEPT FOR THE FACT THAT HIS PASTOR IS A RAVING MANIAC AND HE FOLLOWED HIM FOR MORE YEARS THAN MY MARRIAGE.” So little time, if I could just win the lottery of….fill in the blank, acting, book writing, music career, lottery tickets, life before black tuesday in 1987, or yes, government funding. Most of us are in the middle. You are in great need of the perspective of life. However, you are an excellent debater. Many good wishes to you, and I will remain an avid follower of dooce. I am a fan.
Jon doesn’t need the defending, but you’re just plain rude. If you’re such a dooce fan, then you’re already aware that Jon and Heather’s older daughter developed a condition at a young age called Torticollis Plagiocephaly that prevents them from receiving care from any major carrier. Instead, they depend on more expensive care that they pay for out of pocket. They know, and have acknowledged, that they are tremendously lucky to be able to afford this care. Is it so wrong that he thinks the system can still be better? What was that, caring for the least of my brothers, or some such thing?
And the “mooching the system” phenomenon is (a) not limited to the South, and (b) not nearly as common as you would like to believe, because lo, that would weaken your argument against any number of programs aimed at helping the least among us. Even if socialized medicine isn’t the way to go, the quality of our healthcare system (especially as compared to the cost, which Jon has covered in previous posts) has a LONG way to go. We. Can. Be. Better. Why not try? We are the most powerful nation in the world, we should have the BEST healthcare system in the world.
And by the way, if you are able to pull together to pay $15000 a year for your son to go to school, I would argue that you are not middle class.
@Joanne. Thank you, thank you, thank you. I may like Krugman slightly more than you do, but this outrage over helping the less fortunate with our taxes is pissing me off more than I can describe. Excellent link, too…that’s a really good summary of what’s wrong with a privatized, for-profit healthcare system run wild.
susanruffin,
while i wish jon would retire from this blog anything written by the tired paul krugman and while he wrote in his last post, “the white house turns it up” when in my opinion, they’ve actually dumbed it down, i wish you wouldn’t argue against the possibility of health care reform by scapegoating the poor or attempting to undermine the President b/c of his preacher. I am devout LDS, my husband is even a Mormon Bishop and seriously, some of our members (and leaders) can bring the crazy. but some Christians go to church to worship Christ, not their pastor, preacher, reverend, bishop, etc. and we also believe that the poor are children of God along with us upper-middle class folk. If people need to argue against policy, I wish they’d remember civility. any other form does not contribute to the discussion in a productive way. just sayin’.
also, i’m a lot younger than you. you implied that being older gives you some kind of broader perspective about this issue. if you are willing to listen to folks your age regarding health care reform, please consider watching Wendell Potter in this interview: http://www.pbs.org/moyers/journal/07312009/watch.html
Yeah, I love how this subject always turns personal. If Jon doesn’t agree with you, it’s because you’re right, and he’s dumb. Because he hasn’t seen inner city clinics, vast bodies of lazy people who are willing to suckle at the teat of government and society in general.
I have two points. First (and I’m sure Jon will agree that he doesn’t need defending), some people think that these Armstrong people must live in an Ivory tower, occasionally lowering themselves to mingle with the great throngs of the unwashed at the grocery store, but always arriving in a grand gold plated and chauffeured luxury SUV or some such. Jon is regular people, a profoundly talented photographer and wrangler of CMSs who buys coffee and cereal just like you and me. He’s a musician, a reader, and a thinker. I live where he lives, I’ve seen him around, and to say that he is naive is to entirely dismiss his well-thought-out opinions. He doesn’t live above anyone around here, and doesn’t live a sheltered life by any stretch of your imagination. Jon can pick that thought up from here, if he so chooses, but I’m betting he won’t. Because this isn’t about him, singly. (And no, I don’t belong to the Church of Armstrong… I have no worship complex. He’s just a regular guy, with a regular wife. And they both know that this little “internet thing” they do could end as fast as it started. Thus is the fickleness of that.)
Second point. The idea that people come here for superior health care is laughable indeed. (And TRULY naive.) If you’re interested in a true health care tourism experience, this place is the last on the list of MANY wonderful places to get care that is second to none, at a mere fraction of what inferior care costs here. I’m a Canadian citizen, having now lived here for almost 20 years. I’ve been around both blocks, many times. With the exception of one brother, my family all still lives there. When I hear about some poor slob who comes to the US to get some needed treatment that isn’t available in Canada, I shudder, because I know why it happens.
My younger brother is an RN, and knows this story first-hand: Every year, after January, the US insurance companies, massive HMO’s, etc, come to the nursing and medical schools in Canada, wanting to recruit every single graduating student to come to the US to practice. It’s now called “Shark Week there. The story is that as a medical professional, you can make exponentially more money practicing in the US than you can in Canada. What they FAIL to disclose to these young students, is the malpractice insurance, the huge amount of time it takes to run the insurance system gauntlet to get paid, and the huge costs involved in managing a practice under those conditions.
They are only told that a doctor can make 10 times the money in the US. And so they come. In droves.
Which leaves the system in Canada depleted and stretched after spending money and resources to educate them. Even so, preventative care, and those procedures deemed non-elective, are handled with as much speed and accuracy as is possible under difficult circumstances. Elective surgeries have a waiting list. Some patients may have a differing opinion as to what exactly is elective in their own case, and there is the rub. But generally, critical-needs patients are pushed to the front of the line.
I have so much more to say here, but if I continue, this comment will need chapter headings soon.
So, our system is broken. If you don’t think you ALREADY pay for that throng of lazy people who show up at the ER because they have no access to another doctor, you are SADLY misinformed. A preventive and critical care program is necessary, in order to reduce the costs to all across the board. Imagine if every one of those people could go to a doctor once a year to get a checkup in a regular office instead of showing up in an ambulance at the ER with gangrene because they know they will not be turned away, and had no access to other care.
Remember, private insurers are in business not to provide health care, but to provide a profit and dividends to their shareholders. Period, end of story.
@faydean:
“There are sorry, lazy people out there who take total advantage of others. They exist. ”
This is SUCH a tiresome argument that continues to be made by the GOP. Of course there are “lazy people out there who take total advantage of others”, so what? So we should then instead deny real healthCARE to the by FAR larger majority of our citizens which are not “trying to take advantage of others”? Really now, what is your estimate of those deadbeat cheats and how many of them are required in our society to make it undesirable to provide decent healthcare to the remainder of the general population? And if quality healthcare is provided for all our citizens then what is there to be taken advantage of any longer by these “sorry, lazy people”?
No, those who are unfortunate enough to need good healthcare and can’t afford it whom you deem as “sorry, lazy people out there who take total advantage of others.” are not those whom we should worry about. You are quite right, there indeed “are sorry, lazy people out there who take total advantage of others. They exist.” By FAR the most destructive to our country are those on Wall Street that destroyed our economy and took advantage of us all while lining there pockets with multi-million dollar bonuses. As well as those health insurance execs who “earn” their obscene pay by denying claims by their policy holders and recission.
This tired old argument about all those lazy bums who lurk on every corner whose only goal is to take advantage of others and cheat the system is just more twisted propaganda.
An LA Times Op Ed I thought you’d like
http://www.latimes.com/business/la-fi-hiltzik3-2009aug03,0,6650122.column
Thanks for all the great reading on this topic.
Best to you and your family,
Kyre
I’m going to blog that link! Thanks for sharing!
Point missed, as always, so I’ll back track.
a) I didn’t say Jon was above anyone. I am simply saying that he seems to think that the government run programs in existence are so beyond reproach that there couldn’t be any negative sides to any of them, ie the people who take advantage of them. This healthcare thing, will just be one in a long line of many government programs totally used and abused…at all of our expense (remember WE will pay for this…no one seems to remember that taxpayers fund all this shit).
b) the sorry, lazy people can have health care, sure. I’m simply saying, again, that if you expand the government dole, well then expect more of the same in droves. Sure we pay for the people who take advantage of the system now…but many of them have other stories that revolve around their lack of healthcare. Some real exposure to these people might change of few of your minds.
Hey, I got one for ya. Jon will like this one since it involves Bonnaroo. This past year during Bonnaroo there was a patient who was brought into the hospital where my husband works sicker than shit. He was in his mid 20s, former heroin addict, from out of state and had a bad infection in his heart valve. He had no insurance. He’d already had drug treatment via the system, a heart valve replacement via the system and other treatment for the infection before he headed out for his lovely time at Bonnaroo…only thing is he never took his antibiotics and got sick as crap while enjoying the music. So, off he went to the hospital. Long story short, he had to get another heart valve…down here (did I mention he didn’t live here) and spent more than a month and a half in the hospital…all on the hospital’s dime (no insurance remember since he was a heroin addict in the past).
Funny that, he had money for heroin (but no insurance), then got clean (with no insurance), but got sick (with no insurance) because of his lifestyle, but had money for $400 Bonnaroo tickets and travel across the country…of course it’s all the insurance companies fault since they wouldn’t cover him due to his drug addiction…not like he’s high risk or anything.
Glad the kid is alive, but after an easy $100,000 in costs for his trip to TN, I’m sure the hospital sure did wish he had insurance (though they TREATED him and SAVED his life). Those greedy medical bastards.
There will be arguments that the government would have been there to prevent all this if it had healthcare, right? Yeah, LOL…they’d cover and pay for this guy’s repetitive heart valve replacement in his 20s after him being a heroin user! That’s a real knee slapper.
Hey, maybe he can move to Canada. I bet they’d give him his next one!